美沙酮维持治疗门诊抗-HCV阳性者参加直接抗病毒药物治疗意愿及相关因素分析  

Willingness and related factors of receiving direct-acting antiviral therapy among hepatitis C virus infected individuals in methadone maintenance treatment clinics

作　　者：黎健荣 王丽荣 杨放[1] 李艳[1] 罗玉兰[1] 潘丝媛 徐慧芳 林鹏[1] LI Jianrong;WANG Lirong;YANG Fang;LI Yan;LUO Yulan;PAN Siyuan;XU Huifang;LIN Peng(Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,China;Heilongjiang Provincial Center for Disease Control and Prevention,Haerbin 150030;Guangdong Association for STD and AIDS Prevention and Control,Guangzhou 511430)

机构地区：[1]广东省疾病预防控制中心,广州511430 [2]黑龙江省疾病预防控制中心,哈尔滨150030 [3]广东省性病艾滋病防治协会,广州511430

出　　处：《中国艾滋病性病》2023年第4期424-428,共5页Chinese Journal of Aids & STD

基　　金：广东省医学科研基金项目(B2020174,A2021451)。

摘　　要：目的 了解美沙酮维持治疗门诊抗-HCV阳性者参加直接抗病毒药物(DAAs)治疗意愿的相关因素。方法 以广东省美沙酮维持治疗门诊为研究现场,采用非概率抽样中的方便抽样方法收集抗-HCV阳性者信息,分析其参加DAAs治疗意愿及相关因素。结果 共调查314人,40~59岁占86.0%(270人),男性占86.3%(271人),常住地在城市占74.8%(235人),文化程度初中及以下占81.2%(255人),待业/无业占54.8%(172人)。其中,65.6%(206人)调查对象具有参加DAAs治疗意愿。文化程度、常住地、是否知晓自身疾病阶段、是否接受过丙型病毒性肝炎(简称丙肝)治疗、治愈丙肝对个人重要程度、药物价格可负担程度、医保报销方式是否便捷者,参加DAAs治疗意愿的差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,常住地为城市者(相较于乡镇/农村者,OR=2.163,95%CI:1.064~4.394),既往接受过丙肝治疗者(相较于未接受过治疗者,OR=3.135,95%CI:1.291~7.616),认为治愈丙肝对个人重要者(相较于认为不重要者,OR=27.444,95%CI:5.833~129.118),认为医保报销方式便捷者(相较于认为不便捷者,OR=4.094,95%CI:2.088~8.030)有更高的DAAs治疗意愿。结论 广东省美沙酮维持治疗门诊抗-HCV阳性者参加DAAs治疗意愿不高,应关注常住乡镇/农村者、未接受过丙肝治疗者、认为治愈丙肝对个人不重要者以及认为医保报销方式不便捷者,并针对性采取宣传干预等措施提升其DAAs治疗意愿、促进其参加治疗。Objective To explore the willingness and related factors of receiving direct-acting antiviral therapy(DAAs) among hepatitis C virus-infected individuals in methadone maintenance treatment(MMT) clinics. Methods The data of hepatitis C virus-infected individuals in MMT clinics in Guangdong province were collected via the nonprobability sampling method. The willingness to receive DAAs and related factors were analyzed. Results A total of 314drug users were surveyed, with 86.0%(270/314) between 40 to 59 years old, 86.3%(271/314) of males, and 74.8%(235/314) of residents in cities. People with junior high school education or below accounted for 81.2%(255/314), and those unemployed accounted for 54.8%(172/314). 65.6%(206/314) were willing to receive DAAs. There were factors associated with the willingness of receiving DAAs including education level, the residence place, whether the stage of the disease was known, whether had been treated for hepatitis C before, the importance of curing hepatitis C to individuals, whether the drug was affordable and whether the medical insurance reimbursement method was convenient(P<0.05). Multivariate logistic regression analysis showed that the drug users living in cities had a stronger willingness to receive DAAs than those living in townships or rural areas(OR=2.163, 95%CI: 1.064-4.394). People who had been treated for hepatitis C before had a stronger willingness to receive DAAs than those who had not(OR=3.135,95%CI: 1.291-7.616). People who thought that the cure of hepatitis C was important to individuals had a stronger willingness to receive DAAs than those who thought it was not important(OR=27.444,95%CI:5.833-129.118), and those who thought the medical insurance reimbursement method was convenient had a stronger willingness than those who thought it was inconvenient(OR=4.094, 95%CI: 2.088-8.030). Conclusions The willingness to receive DAAs was not high among hepatitis C virus-infected individuals in MMT clinics in Guangdong province. Attention should be paid to those who live i

关 键 词：美沙酮维持治疗 抗-丙型肝炎病毒阳性 直接抗病毒药物治疗 意愿 

分 类 号：R512.6[医药卫生—内科学]